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Discussion Starter #1
My 13yr old cat is going through so many health problems lately. We finally got her Sinus infection taken care of and now all of sudden she's gone down hill real quick. Losing weight fast (you can feel her bones) not eating occasionally she'll eat some dry food. She drinks a lot of water and urinates frequently. For the last month she has been crying like howling in pain during the day. She's very lethargic and depressed.

We took her to the vet they did a number of test took a urine sample. My vet said there was blood in the urine and it was cloudy. We got the results today and the vet said she had high levels of calcium in her blood which would indicate some sort of cancer more than likely intestinal. She said we could do an ultrasound to determine how advanced the cancer is. She gave me a prescription food to try and force feed her and told me to call her in a week. I don't understand, if my poor girl has cancer then I don't want to delay the enivitable. My vet won't give me a straight answer about her life expectancy or what to do.
 

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Discussion Starter #3
She didn't indicate when we should do the ultrasound. She told me to try and give her the food and call her in a week.
 

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I am so sorry for your cat's illness. If you don't have them already, I strongly urge you to go to your vet's tomorrow and get copies of all of your cat's lab results. You'll need them in order to make sense of the information you research online, and we'll need to see them posted on this thread in order to provide you with the most useful and relevant suggestions and guidance.

The following explanation of high calcium came from this website:

Broadway Veterinary Hospital / Laboratory Assessment Descriptions

"The calcium level high. This is always concerning. A persistently high calcium level, or hypercalcemia, can be toxic to kidney cells and it leads to poor muscle function, especially within the intestines, heart and limbs. It can also lead to hypertension, urinary stones and tissue mineralization. A high calcium level can be due to kidney disease, certain cancers, over-supplementation, Vitamin D toxicity, a hormonal disease called hyperparathyroidism or it may be idiopathic, meaning it is occurring for unexplained reasons."

As you can see, cancer is only one of the potential causes of high calcium. There may have been other indicators in your cat's lab work that pointed toward a cancer diagnosis, but without seeing the test results, that would only be a guess. An ultrasound may provide more diagnostic information, but a biopsy would likely be the only definitive diagnostic option for cancer.

If I were you, I wouldn't deal with a vet who sent my cat home with nothing more than a prescription food that she almost certainly won't eat, and told you to come back in a week. Given your cat's current condition, it sounds to me like your vet is sending her home assuming that she'll die before she has to deal with her again. Personally, I'd find another vet immediately - one who actually cares about my cat's critical condition and is willing to take an immediate and proactive role in diagnosing and treating my cat.

There's certainly no value to your cat in allowing her to continue to suffer. Either take her to a vet who will treat her with the urgency, compassion, and competency she needs and deserves, or have her euthanized. She needs you to get her the help she needs, one way or the other.

I wish your cat the best possible outcome.

Laurie
 

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Discussion Starter #5
Thank you for you time and advice Laurie.

We took Liza to another Vet this morning for a second opinion. She said what my other Vet had diagnosed - Cancer. With a high Calcium level of 13 (normal range is between 8-10) and her age against her then it's more than likely cancer of some kind. She did an exam and Liza is very sensitive in the abdomen. So she assumes there is a mass of some kind there. We could do an ultrasound to be sure and to find out how far the cancer has spread and do a biopsy. But to be honest i don't know if I want to put Liza through another procedure. They would have to put her under to do the ultrasound and I don't think she is strong enough for anymore tests. The vet mentioned she doesn't think she has much time left. The ultrasound will only confirm what we know. We really can't afford any surgery or chemo and I don't want to put her through that. Poor thing has been in and out of the Vets so many times during the past 2yrs.

My husband and i have decided to let her go, we are having someone come to the house on Friday.
 

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Natalie,
Hugs to your and your husband, and petpets to Liza.

You are being most kind and merciful not to stress her out anymore than she already has been.

Praying for continued comfort, and a warm blanket of love for all of you in the next few days.....
 

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It's never an easy decision to make, but if she is suffering and in pain that makes it easier, and having the vet come to your come to your home even better for you and your beloved cat, who would be upset with yet another trip to the vet. All the very best.
 

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I understand your concerns about doing riskier diagnostics to verify Liza's diagnosis. One of my cats has what I assume to be intestinal lymphoma, but I won't be doing a surgical biopsy on him, either. His current management protocol wouldn't change with a definitive cancer diagnosis, because I wouldn't put him through chemo, and I'm not willing to put him through the risk or pain of abdominal surgery. Sometimes we have the hateful task of choosing the lesser of two evils ... or what we do our best to determine is the lesser of two evils. We make these heart-wrenching decisions based on our knowledge of and love for our feline family members. That's the best we can do.

Try to spend these next two days basking in the love of Liza, and please, return to us here if you need support and understanding to get you through.

Laurie
 

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Discussion Starter #10
Thank you everyone for your support it's a very hard decision to come to terms with one that I keep doubting myself on. I keep thinking maybe it's something we can cure, maybe we should do the ultrasound to be sure - even though financially we just can't. Why am I doubting this when I know in my heart it's the right thing to do. Liza has been telling me for weeks with her cries, howls & moans something's not right.
 

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Doubt and guilt are part and parcel of the life and death responsibility we assume over another living creature. I've come to accept that over the decades. The things we would have to do to our beloved 4-leggeds in order to achieve absolute certainly in medical decisions sometimes can't be justified by the potential outcomes. That doesn't make it any easier to reach an "uncertain" decision, I know, but it does inject a humane perspective that medicine itself doesn't necessarily offer. You have to trust Liza. She has told you what she needs.

Laurie
 

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Discussion Starter #13
Very true! Can I ask Laurie what procedures are you doing with your cat? Did you do an ultrasound was there a mass in the intestines? I keep going back on if I should just schedule her for an ultrasound. But I don't know what good it will do. Liza has been on Prednisolone for about a month now due to her sinus infection. The vet said for us to keep her on this and up the dose from half to one a day. She said this can shrink the tumor. Liza has been rejecting them the past week when I do manage to get it down her she does on occasion throw it back up. Obviously this won't cure the cancer but will buy her sometime, how much time though? I haven't been able to get her to eat much I do have to force feed her and she does on occasion throw that back up to.
 

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Very true! Can I ask Laurie what procedures are you doing with your cat? Did you do an ultrasound was there a mass in the intestines? I keep going back on if I should just schedule her for an ultrasound. But I don't know what good it will do. Liza has been on Prednisolone for about a month now due to her sinus infection. The vet said for us to keep her on this and up the dose from half to one a day. She said this can shrink the tumor. Liza has been rejecting them the past week when I do manage to get it down her she does on occasion throw it back up. Obviously this won't cure the cancer but will buy her sometime, how much time though? I haven't been able to get her to eat much I do have to force feed her and she does on occasion throw that back up to.
I've never typed all of this out before, but I think it's important to try to put Noddy's undiagnosed condition into the most informed possible context. Noddy is a massive cat who spent the majority of his adult life morbidly obese at 26+ lbs. Aside from the obesity itself and a mild limp in one front leg probably caused by that obesity, he was always the picture of good health. He was lazy, of course, but his appetite was strong, his stomach happily digested the high-carb kibble diet I was feeding at that time, and he never had a sickly day.

Then in 2007 at the age of 12, Noddy had a diabetes scare that made me finally get serious about taking all of that extra weight off of him (and my other cats). Over the next 18 mos, Nods gradually and deliberately lost about 10 lbs and achieved an optimal weight of 16.5 lbs.

Coincidentally or not, it was during the weight loss period after I transitioned him to a primarily raw diet that Noddy started developing GI problems. He ate the raw diet without problems for several months, then suddenly started vomiting every bit of raw meat/organs/bones I tried to feed him. I necessarily switched him to canned and kibble foods. From then on, Noddy would cycle through periods when he could tolerate one type of food (canned, kibble, or raw), but not another.

About six months ago, Noddy suddenly started vomiting everything he ate. He couldn't keep anything down. He dropped weight quickly. My vet prescribed metoclopramide to control the vomiting, which Noddy has been taking twice daily since the constant vomiting started. The vomiting stopped, for the most part, but Noddy still had very little appetite. The weight loss continued, and he clearly didn't feel well. I gave him 1/8 Zantac 75 daily to control stomach acid, and anywhere from 100-150 ml of Lactated Ringer's subQ daily to keep him hydrated. I occasionally also gave him 1/4 of a cyproheptadine to stimulate appetite, but it didn't work on him.

After Noddy had lost 3 lbs with no sign of stopping, I finally decided to risk Prednisolone. Because of Noddy's history of morbid obesity, pred carries a substantial risk of triggering diabetes in him, which is why I had been resisting putting him on it earlier. But between the risk of diabetes and the reality of starving himself to death, I opted for the diabetes risk. He took prednisolone at a dose of 5 mg twice daily for the last several months, during which time he gained back two of the three pounds he had lost.

Unfortunately, Noddy's appetite is still minimal, so I've been supplementing the small amount he eats on his own with syringe feedings for months now. His syringe slurry is made up of premium quality canned foods, cheap "tasty" canned foods, Nutristat, fish oil, potassium gluconate, methylcobalamin, folic acid, acidophilus, taurine, and Miralax.

Once Noddy's condition stabilized and he was no longer either improving or getting worse, my vet recommended I slowly start reducing his pred dose, which I did. Unfortunately, even the tiniest dose decrease caused him to backslide and start to act noticeably sicker. He started rejecting his syringe feedings and started vomiting occasionally, in spite of the metoclopramide. I returned his dose to 5 mg twice daily, but so far, his condition has not improved back to where it was before the dose decrease. It's only been a few days, though, so I'm still hopeful. I've started giving him 1/8 Zantac 75 once daily again, and that may be helping a bit to settle his stomach.

Throughout all of this, the only notable issue in his bloodwork has been renal values at the upper edge of the normal range, indicating that Noddy has been in early stage renal failure for more than a year. His renal values have been stable during that time with no obvious progression of the disease so far.

Noddy has experienced no abdominal tenderness at all, and my vet has been unable to palpate any obvious masses. My vet has speculated that Noddy may have pancreatitis, but pancreatitis typically causes substantial abdominal tenderness, so I don't believe that's at play. I suspect that Noddy has either intestinal lymphoma or IBD, both of which I would be managing the same way I'm managing him now, so further diagnostics seem unproductive. I have not had an ultrasound or any type of biopsy performed on Noddy.

My boy is worrying me since I tried reducing his pred dose. He's had several bad days in a row now, and it's stressing us both out. I hope that returning the pred to his original dose and adding Zantac 75 to his daily regimen will turn him around again.

I hope you can follow all of this and not get too confused by it. Please feel free to ask me any other questions you may have about Noddy's management or history. There are a number of similarities between Liza's condition and Noddy's, but there are also some key dissimilarities.

The only advice I would offer you now is to make whatever decision you're going to make about how to proceed with Liza very quickly so as to minimize any suffering. If you decide to pursue further diagnostics, do them as soon as possible. If you decide to euthanize, don't delay that, either.

I wish you and Liza the best possible outcome, whatever your decision.

Laurie
 

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So sorry to hear about your kitty's illness. I just wanted to share our experience with you. Our kitty stopped eating and became lethargic right after her rabies vaccination. We had tests done and it was cancer. They wanted to do ultrasound and needle aspiration of the tumor. If those tests confirmed the type of cancer then they would recommend chemo.

Best case scenario was 4-6 months life expectancy. They do chemo in hazmat suits and we wouldn't be able to be by her side for the procedure. There was no way we were going to put our baby through that. Then we made one of the hardest decisions of our lives. Our choice was to euthanize her in our home with my wife grooming her and me scratching her ears. It was very peaceful. Miss her horribly. It was just 2 months ago.

She was just so robust and fearless and within 2 weeks she was obviously in pain and miserable. She passed on before she was skin and bones. She could still purr softly. She could still walk past us and ignore us like the queen of the house has a right to.

We can't make the decision for you, but I just wanted to share our experience with you. Two more things I would like to mention. We got some painkiller that you can squirt on their gums. That made her so much more comfortable. Buprenex. We also got her to drink some canned tuna juice.

Once again I am so sorry your kitty is so sick. Please keep us updated - I will be looking for posts from you. I encourage you to stick around the forums and read as well as post away. You will never find a nicer bunch of cat people to help you through this very tough time in your lives. Take care, Chuck.
 

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Natalielucy, you said in a previous post... "I know in my heart it's the right thing to do. Liza has been telling me for weeks with her cries, howls & moans something's not right."
To me that sounds loud and clear that she is in pain, suffering, andhas she lost complete interest in everything? I've let cats go on for too long, and believe me, the guilt afterwards for allowing the cat to suffer is so much worse than letting it go a little too soon. If the cat has lost interest in everything, including eating, it's time. All the best in your difficult decision.
 

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Discussion Starter #17
Laurie - thank you for telling me Noddys story. Yes there are similarities but also dissimulatirs. Her bloodwork is all normal except from the high calcium. Her kidneys are fine. Noddy has been doing well on the steroids and now when you've reduced his dose he's getting worse. That's how I feel with Liza she's had 3 good days on the pred and she's doing a little better eating a little more on her own but I think this is down to the steroids.

This morning she wet on my bed I guess she didn't have the energy to use the litter box. We have the appointment still set for tomorrow afternoon to ethaunize her. We do however have another appointment in the morning for an x-ray to determine of there is a mass. We wanted to do an ultrasound but the cost is a little high. Do you think an x-ray is wise?

Chuck - thank you for sharing your story. Can I ask what results made your kitty have a definitive diagnosis of Cancer? Was her calcium high also? I'm trying to understand what other things in bloodwork they go off to determine its Cancer.
 

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Noddy has been doing well on the steroids and now when you've reduced his dose he's getting worse.
That does seem to be what's happening, yes, but I really have no way of definitively correlating his condition with the pred.

Do you think an x-ray is wise?
It can't hurt, but it also may not identify soft tissue masses, from what I understand. Also, even if it does indicate abnormalities, I don't think it can differentiate between, say, a foreign body obstruction and a tumorous mass. In short, I don't believe an x-ray is going to give you any definitive information. I could be wrong about that, though. You should certainly discuss it with the vet to find out what information you may gain from an x-ray.

I'm trying to understand what other things in bloodwork they go off to determine its Cancer.
This, too, is something you need to discuss with the vet. I think the euthanasia is going to be harder on you than necessary unless you gain some understanding of this situation. The way to do that is to make it clear to your vet that you need to understand exactly how the likely cancer diagnosis was reached. Don't stop asking questions until you are satisfied that the vet has told you everything the vet knows at this point.

Laurie
 

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Discussion Starter #19 (Edited)
That does seem to be what's happening, yes, but I really have no way of definitively correlating his condition with the pred.
That's how I feel with Liza. She's doing better on the Pred but it's not going to solve the root cause of the issue just suppress it. The Vet told me today if she's doing better on the Pred then not to Euthanize her as there is a chance she can pull through this as Pred can shrink tumors. But in my mind the cancer will eventually win, and I don't want to put her through all this.

In short, I don't believe an x-ray is going to give you any definitive information. I could be wrong about that, though. You should certainly discuss it with the vet to find out what information you may gain from an x-ray.
Thanks we will do that, I guess we thought that if the x-ray could determine some sort of a mass we would know in short that it was cancer.

I think the euthanasia is going to be harder on you than necessary unless you gain some understanding of this situation. The way to do that is to make it clear to your vet that you need to understand exactly how the likely cancer diagnosis was reached.
From what I understand cancer is the more than likely option due to her age and symptoms along with the bloodwork. I pretty much got that from the second vet but the only way to be sure was to do an ultrasound. Now I could wait till Monday for my regular vet to do it for $200 but I had a recommendation of the second opinion vet and they can do it tomorrow for $400. It's a lot of money that we don't have right now, I have drained my kitty account. I also don't want to wait till Monday, as I feel the longer I put it off the longer she can be in pain for.

This is such a hard decision to make, I do appreciate your time though.
 

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Discussion Starter #20
Natalielucy, you said in a previous post... "I know in my heart it's the right thing to do. Liza has been telling me for weeks with her cries, howls & moans something's not right."
To me that sounds loud and clear that she is in pain, suffering, andhas she lost complete interest in everything? I've let cats go on for too long, and believe me, the guilt afterwards for allowing the cat to suffer is so much worse than letting it go a little too soon. If the cat has lost interest in everything, including eating, it's time. All the best in your difficult decision.
Thank you. Yes I have felt that she has been telling me that she's in pain. Although she hasn't been crying for the last few days probably because she's been on the steroids.
 
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